Creswick Academy

Early Years Application Form

Creswick Nursery School

Early Years Application Form

Forename(s)

Family Name

Date of Birth

Gender

NHS Number

Your relationship to the child (eg mother/father/carer/stepmother/social worker)

Your child's permanent address (at time of application)

Special Educational Needs - does your child have a Statement of Special Educational Needs or Educational Health and Care Plan (EHCP)?

At risk - is your child, or a sibling of your child, subject of an inter-agency child protection plan and has been placed on the Child Protection Register? (Please provide evidence with this form.)

Children in Public Care - is your child looked after, or was previously looked after and is now adopted, or with a child arrangements or special guardianship order?

Social or medical reasons - do you have a particular medical or social need to go to this school? (Please provide supporting evidence with this form.)

If you have a sibling at this school, please enter their name and date of birth

Early years setting child attends or has attended (if applicable)

Will you be entitled to 30 hour funding?

Are you intending to use the 30 hour funding?

Please complete the details for both parents if living at the same address. Parent/Carer 1 - Title

Parent/Carer 1 Forename

Parent/Carer 1 Surname

Parent/Carer 1 DOB (DD/MM/YYYY)

Parent/Carer 1 National Insurance Number

Parent/Carer 1 National Asylum Support Service (NASS) Number (if applicable)

Parent/Carer 1 Address

Parent/carer 1 Email address

Parent/carer 1 Telephone number (daytime)

Parent/Carer 1 Mobile

Parent/Carer 2 Title

Parent/carer 2 Forename

Parent/carer 2 Surname

Parent/carer 2 DOB (DD/MM/YYYY)

Parent/Carer 2 National Insurance Number

Parent/carer 2 National Asylum Support Service (NASS) Number (if applicable)

Parent/carer 2 Address

Parent/carer 2 Email address

Parent/carer 2 Telephone number (daytime)

Parent/carer 2 Mobile

Declaration - The information I have given on this form is complete and accurate.

I understand that my personal information will be held securely and will be used only for local authority purposes.

Creswick School will use this information to apply for Pupil Premium on your behalf.

I agree to Creswick School using this information to consider my application for a nursery place.

I understand that if any part of this completed application form is found false the offer of a place will be withdrawn.

I understand that the completion of an application form does not guarantee a place in the nursery class.

I understand that, if offered a place in the nursery class, I will have to apply separately for a place in reception.

Signature of parent/guardian

Date

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Creswick Academy

Early Years Application Form

Creswick Nursery School

Early Years Application Form

Contact Us

Sir John Newsom Way, Welwyn Garden City, Hertfordshire AL7 4FL

admin@creswick.herts.sch.uk

01707 323038

Our use of cookies

Necessary cookies

Creswick Academy

Creswick Academy

Early Years Application Form

Creswick Nursery School

Early Years Application Form

Contact Us

Sir John Newsom Way, Welwyn Garden City, Hertfordshire AL7 4FL admin@creswick.herts.sch.uk 01707 323038

Our use of cookies

Necessary cookies

Analytics cookies

Sir John Newsom Way, Welwyn Garden City, Hertfordshire AL7 4FL

admin@creswick.herts.sch.uk

01707 323038